How a Partnership with a TPA can be Beneficial

How a Partnership with a TPA can be Beneficial

Meet Ed

Instructor Ed Jones has over 30 years of experience in theindustry, has the title of MasterWater Restorer, is an Institute ofInspection Cleaning andRestoration Certification (IICRC)-approved instructor, and hasserved on the S500-2021consensus body committee todevelop the most recent standard.

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In today’s restoration industry Third Party Administrator (TPA) vendor programs have grown dramatically over the years.  Love them or hate them, they are here to stay so here are some tips on how to survive and maybe even flourish when building relationships with TPA’s.

  1. To earn claim referrals on a consistent basis you must be good at the "little things!"  Show up on time to every appointment, look and sound professional by driving clean, well-logoed vehicles, technicians wearing uniforms with photo ID badges prominently displayed, wearing shoe protectors, and leaving every work site clean and organized.  Find a way to "WOW" your customer and get them to tell everyone about their great experience with your company.  Sounds simple, but you would be surprised how easy it is to separate your company from the rest by just focusing on superior customer service.
  2. Even though most TPA's have metric driven vendor selection processes, it is still a relationship business, just like it was years ago.  Take the time to build those TPA relationships, albeit many times over the phone, for it will make them more comfortable using your company or calling you to help them when another vendor messes up.  I've seen some restorers keep busy just cleaning up after everyone else!  Just by answering all communications quickly you can set your company apart from the rest.
  3. Timely documentation is the one area where many restoration companies fail, thus they risk dropping their company's rank in the selection process and potentially delaying payments.  Want to earn the most claim referral opportunities possible?  Be good at documenting your job scope and estimates, daily readings and updates, and telling your restoration story with a good sketch with dimensions, daily readings, combined with well-labelled photographs that justify all your charges.  All materially interested parties want the claim to be resolved quickly and if you can provide great documentation in a timely manner, you will put your company at the top of every vendor program selection list.  This includes embracing the mobile app that may be mandated, whether you like it or not, and learning how to transfer the information needed in the most efficient way possible.  Don't be a complainer but do provide good feedback on how we all can make the claims process more efficient.
  4. Keep your company profile updated and exceed what is normally required.  The bar of expectations has risen, and you need to be attentive to show that your company is on top of keeping your technicians certified, background checks, insurance liability requirements met, etc.  To prove your company is trustworthy you must meet all vendor program requirements and keep them updated.
  5. Resolve issues quickly.  When there is a problem, resolve it as quickly as possible and be sure to take care of the policyholder.  If you disagree with a judgement or feel the allegations are unreasonable you can communicate that in a respectful manner to the TPA representative.  Take good notes and be prepared to use industry standards, if possible, to show you performed properly.  Never complain about the insurance carrier to their policyholder instead follow the chain of command at the TPA to plead your case and always be respectful and professional.  By the same token, if someone at the TPA or an adjuster does not communicate timely or properly it is fair to communicate that to the TPA or carrier leadership, so they are aware, which is why taking good notes on ALL communications is so important.  Save all emails & texts and be sure to summarize all verbal discussions in your file notes, including date and time of the call.

In summary, there are several advantages of participating in TPA vendor programs.  No expense to obtain new jobs, increased volume of work which can offset any payment discounts, quicker payments that come directly from the TPA to your checking account, direct payments not requiring customer endorsements, opportunities to obtain claim referrals from multiple insurance carriers, and finally the many documentation requirements protect your company better from unreasonable allegations or potential lawsuits.  It’s better if someone else says you did it right vs. you saying you did it right!


Be the restoration company that doesn't complain about increased hoops to jump through but instead embraces the way vendors are pre-qualified and held accountable for you know it will weed out the ones that can't keep up and just want to complain how TPA's are so unfair.  I’m not saying that TPA’s are always right and if you see where a TPA requirement doesn’t follow industry standards or detracts from efficiency or your care of the policyholder certainly offer good feedback. Be the company everyone loves to work with that has great knowledge, the latest technology, superior customer        
service, and a great attitude!

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